AccountId: 011433970860
ContactId: 7915dc41-a864-416e-933f-390bbfe248da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 519500 ms
Total Talk Time (AGENT): 188508 ms
Total Talk Time (CUSTOMER): 112659 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/31/7915dc41-a864-416e-933f-390bbfe248da_20250331T12:34_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name's [PII]. I'm trying to verify dental benefits for a patient, please just for Endo.
[AGENT][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] You're needing to verify endomic benefits for a member, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number.
[CUSTOMER][NEUTRAL] That looks like um
[CUSTOMER][NEUTRAL] Looks like 016289999.
[AGENT][NEUTRAL] OK, [PII], thank you. Give me one moment to get a.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Where's the information pulled up please?
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], any information that I do provide.
[AGENT][NEUTRAL] And for you today will be a verification of that and not so first off, if you could please verify your patient's name and date of birth.
[CUSTOMER][NEUTRAL] The patient's name would be [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you do not need eligibility, you're only needing benefit information?
[CUSTOMER][NEUTRAL] Just need to see if she's um met her deductible and what her maximum she's used also please.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And again, any information that I do provide for you would be a verification of benefits and not a guarantee of payment. So as of now she has a she still has $16.
[AGENT][NEUTRAL] To meet on her $50 calendar year deductible.
[AGENT][NEUTRAL] And she has used $228 of her 1500 calendar year maximum benefit as of now.
[AGENT][NEUTRAL] Now, do you have a fact back of benefits, [PII], or do you already have, have you already received one of those from APL?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Um, a fax back, no, it didn't give me the option.
[AGENT][NEUTRAL] OK, we have a fax, I have a fax back of the benefits that are covered under this plan that has all of the information on there, anything not.
[CUSTOMER][POSITIVE] Awesome that that'd be great if you can send that to us.
[AGENT][NEUTRAL] Listed on this fax backpacking means it would not. Would you like for me to send that? Sure. Give me just one moment to get that pulled up please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And are you showing I, I believe you're brand new for us. Would you need a W-9?
[AGENT][NEUTRAL] Yes, if you have, if you have never filed with us, yes, ma'am.
[AGENT][NEUTRAL] We would.
[CUSTOMER][NEUTRAL] I don't think we have
[CUSTOMER][NEUTRAL] OK, can I fax that to someone or does it have to be sent to her? OK.
[AGENT][NEUTRAL] You can
[AGENT][NEUTRAL] You, you can, uh-huh, but give me just a moment to get this information down and I'll tell you where the other needs to be sent.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][NEUTRAL] It just takes a moment to load this information, so bear with me.
[CUSTOMER][POSITIVE] Mhm, no problem.
[AGENT][NEUTRAL] And will the facts need to be put to your attention or is that not necessary, [PII]?
[CUSTOMER][NEUTRAL] Not, not necessary. It's right in front of me, so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Appreciate the offer though.
[AGENT][POSITIVE] OK, well, you're welcome.
[CUSTOMER][NEUTRAL] Does this insurance pay at a percentage or is it a fee schedule?
[AGENT][NEUTRAL] This one is based on a percentage of the use coverage services are based on a percentage of the UCR of the service region.
[AGENT][NEUTRAL] And that information is also stated on the fax back.
[CUSTOMER][POSITIVE] OK awesome.
[AGENT][NEUTRAL] And then what is a good fax number for you, [PII], to send this fax back to?
[CUSTOMER][POSITIVE] OK, awesome.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And again, that was [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, all right, so let's see.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I just want to make sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh, I'm very sorry about that.
[AGENT][NEUTRAL] OK, so you can fax that to [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, I'll get that right over there and the fax is on its way. OK, I appreciate your help. Thank you so much and you have a nice day.
[AGENT][NEUTRAL] Well, you are starting for and then I hope you do too and then just one last piece of information once we have processed a claim here at APL [PII], we do have a.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] Portal in which you should be able to check claim status.
[AGENT][NEUTRAL] And that claim status uh can be checked at secured. Uh, our portal for that is secured.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][POSITIVE] I appreciate it.
[AGENT][POSITIVE] OK. Well, you're very welcome. And again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] Have a great day.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] No, that's it. Thank you so much. Take care. OK, bye now.
[AGENT][POSITIVE] OK. You're certainly welcome. Have a great day too, and thank you again for calling in.